Final Flashcards
Which of the following conditions usually originates at the lower portion of the anterior mediastinum
Teratoid cyst
Which 1 of the following criteria distinguish a thoracic spine series from a chest series
Frontal view
PA
72 inch FFD
100 kVp
A normal chest series
Shows lungs with blood vessels smaller in the upper lung and larger in the lower lung
A vanishing tumor or phantom tumor of the lung could be assocaited with
Cardiac disease related to systemic hypertension
With large pneumothorax, one might see
Absence of lung markings in teh involved hemithorax with same side passive atelectasis
Multiple small round calcifications in the liver and spleen suggest
Histoplasmosis
A patient presenting with stringy, irregular, linear upper left lung densities and retraction upward of the left hilus most likely has
TB primary
The most common cause for a Stanford Type A (Type II) aneurysm is Marfan’s syndrome
True
Middle mediastinal masses include
Bronchogenic cyst
Aortic aneurysm
Esophageal aclasia
TB, sarcoidosis, connective tissue diseases and pneumonconiosis all have ____ in common
Fibrosis
Signs of emphysema include
Low flat diaphragm, blunt ended costophrenic angles, hyperlucent lung
Which of the following are characteristic findings of mitral stenosis
Pulmonary edema, pulmonary venous hypertension, left atrial enlargement
A good diagnostic film for pleural effusion would be
Lateral decubitus with affected side down
Pancoast tumor is a
Bronchogenic cancer
Aortic coarctation
Enlarges the ascending aorta
Which of the following cannot be detected or evaluated on the abdominal plain films
GI mucosal detail
What percentage of malignant mesothelioma will be associated with asbestosis approximately
80%
A number of connective tissue diseases have been reported to occur with increased prevalence in patients with pneumonconiosis. The combination of coal workers pneumoconiosis and rheumatoid arthritis is referred to as
Caplan’s syndrome
A mycetoma would most likely be found within the lung; however, they can also be found in paranasal sinuses. Which of the following could mimic a mycetoma within the lung
Fungal cavitation
A patient with mechanical ileus will have a visible gas pattern int eh rectum where as the patient with a paralytic ileus typically will have no rectal gas
True
Which one of the following causes would be an example of pulmonary edema secondary to increased capillary permeability`
Heroin overdose
High altitude edema - inc permeability
Mitral stenosis
Inc pressure
Left atrial myxoma
Inc pressure
Congestive heart failure
Inc pressure
Hypertrophic osteoarthropathy is a syndrome and is most often a clinical indication of
Bronchogenic carcinoma
The pancoast syndrome consists of
Horner’s syndrome, arm pain, neck pain, apical pulmonary mass
Which condition clinically associated with acute onset of chest pain and difficulty breathing could have a normal chest x-ray
Thromboembolic disease
Indirect roentgen signs of lung collapse include all of the following except
Vascular or bronchial crowding (herniation of lung tissue, tracheal deviation, narrowed rib cage on collapsed side all included)
Eisenmenger physiology results in
Right to left shunting from shunt reversal and eventually right ventricular failure
Three direct signs of lung collapse, seen on plain film are
Increased lung opacity
Displaced fissures
Vascular or bronchial crowding
Calcified pelvic phlebolyths are very common and may be difficult to distinguish from
Urinary tract stones
A dynamic or paralytic ileus may be caused by
Spinal fracture or acute disc herniation
A meniscus sign may indicate
Free pleural effusion
A pelvic cyst having a very thin rim of calcium within the wall and multiple small irregular calcific densitites appearing like teeth is a diagnostic of
Ovarian teratoid cyst
Which cardiac examination does not utilize ionizing radiation
Echocardiogram
On a thoracic spine series, a pt was found to have a fusiform shaped mass denisty at the retrocardiac space on teh lateral view and a soft tissue density superimporsing the lower thoracic spine on the AP view. The differential would include all of the following except
Ectopic fibroid or foramen of morgagni hernia
An air-fluid level seen behind the heart on a PA and lateral chest x-ray is probably
Hiatal hernia
With large amounts of free pleural effusion
There may be a mediastinal shift to the unaffected side
The most sensitive chest film for pleural effusion is
The lateral decubitus view with trendelenburg positioning
Which of the following is associated with ASD and hypoplastic or nonfunctioning right ventricle
Tricuspid atresia
Which combination of defects would have a high volume left to right shunt called loop/loochenbacher’s syndrome
ASD with mitral stenosis
Which combination of imaging of choice for gall bladder disease is
Ultrasound
Which one of the following is associated with a common ventricle and a large single blood vessel leaving the heart
Truncus arteriosus
Cephalic shift in pulmonary vascularity associated with venous hypertension, in the pulmonary circulation causes large upper lung blood vessels, in the upright position which may equal the size of the lower lung blood vessels
True
Which one fo the following is non-cyanotic
Ebstein’s anomaly
Cyanotic
Tetralogy of fallot
Trilogy of fallot
Transposition of the great vessels
VSD + Eisenmenger
Which condition would not be considered a precursor for congestive heart failure
Pulmonary fibrosis - cor pulmonale
Which type of aortic dissection is most common and has the worst prognosis using the debeke and stanford classification
Type I
Which aortic dissection is the least common
Type II - marfan’s
What is the classic sign of pulmoanry arterial hypertenstion
Large pulmonary artery
Mitral stenosis may produce the radiographic appearance of
Left atrial enlargement (kerley B lines)
Mediastinal teratoma’s are usually located in which compartment
Anterior
Mediastinal hiatal hernias are located in which compartment
Middle
Chamber enlargement confined to the right atrium would be expected with which one of the following
Ebstein’s anomaly
Which primary malignancy is responsible for the greatest number of hematogenous metastatic cases
Breast cancer
Eisenmenger physiology converts a left to right shunt to a right to left shunt. T/f
True
Eisenmenger physiology is an insignificant complication of chronic left to right shunting. T/F
False
With regard to lung tumor staging, which of the following combinations of TNM has the worst prognosis
T1 N0 M0
Then T1 N0 M1
Then T4 N3 M0
Posterior eventration of the hemidiaphragm may be associated with which one
Foramen of bochadalek
Carcinoid tumor is the most common type of bronchialar carcinoma (it was bronchial adenoma)
True
Patent ductus arteriosus with eisenmenger physiology would have cyanosis
In the lower extremity only
In large bowel obstruction 60-80% of cases are related to tumors. Approximately 10% of cases are related to diverticular disease and approximately 5% of cases are related to volvulus. Sigmoid volvulus is much more common than cecal volvulus
True
Pulmonary infarction
Is seen as a pulmonary mass
The most common primary malignancy of the lung is
Bronchogenic carcinoma
Which of the following would not be the cause of left ventricular enlargement
ASD
With bowel obstruction, closed-loop obstructions are considered to be surgical emergencies because
Of high incidence of bowel infarction and perforation
Pneumocystis carinii pneumonia is a pulmonary infection
Most commonly seen in patients with immune system suppression - AIDS
Which of the following would not be the cause of right ventricular enlargement
Ebstein’s anomaly
The significance of porcelain bladder is
Increased risk of carcinoma
Calcification within the pancreas is usually associated with
Alcoholism
Which cause of pleural effusion would be expected to produce an atypical effusion
Congestive heart failure
All of the following must be considered in teh differential diagnosis of ???? Except
Hernia
An increased incidence of cholelythiasis would be expected in pateints with
Diabetes mellitus
Mechanicla ileus may be caused by
Cholelythiasis
Gallstone ileus is caused by
A gall stone lodged at iliocecal valcve
Emphysematous cholecystitis is strongly associated with
Diabetes mellitus
Imaging of choice for a gall bladder is
Diagnostic abdominal ultrasound
The most frequent cause of pneumoperitinium is
Ruptured gastric or duodenal ulcer
The most common reasons for mediastinal lymph node calcifications include
Fungal infections and pneumoconiosis
Hodgkins disease may create a radiologic appearance of
Bulky mediastinal widening
Combination of kerley’s A and B lines, interstitial pulmonary edema and cephalic shift of pulmonary vascularization suggest a diagnosis of
Congestive heart failure
Which of the following is not considered to be an associated cause of bronchogenic cancer
Previous histoplasmosis
Esophageal achalasia may present as
A middle mediastinal mass
Pulmonary arterial hypertension can be related to all of the following except
Tetralogy of fallot
Posterior mediastinal masses may
Are associated with adjacent bone remodeling changes
An air fluid level seen in the maxillary sinus on a vertex view is most likely related to
Acute sinusitis
Posterior mediastinal masses include
Neurogenic tumors
Spinal disease
Aortic aneurysm
All of the following must be considered in the differential diagnosis of Thymoma except
Hernia
An increased incidence of cholelythiasis would be expected in patients with
Diabetes mellitus
Mechanical ileus may be caused by
Cholelythiasis
Gallstone ileus is caused by
A gall stone lodged at ilio cecal valcve
Emphysemitus cholecystitis is strongly associated with
Diabetes mellitus
Imaging of choic for gall bladder is
Diagnostic abdominal ultrasound
The most frequent cause of pneumoperitonium
Ruptured gastric or duodenal ulcer
Most common reasons for mediastinal lymph node calcification include
Fungal infectious and pneumoconiosis
Hodgkin’s disease may create a radiologic appearance of
Bulky mediastinal widening
Combination of kerley’s a and B lines interstitial pulmonary edema, and chalic shift of pulmonary vascularization suggest a diagnosis of
Congesative heart failure
Which fo the follwoing si not considered to be an associated cause of bronchogenic cancer
Previous histoplasmosis
Esophageal aclasia may present as
A middle mediastinal mass
Pulmonary arterial hypertension can be related to all of the following except
Tetralogy of fallot
Posterior mediastinal masses may
Are asosciated with adjacent bone remodeling changes
An air fluid level seen in the maxillary sinus on a vertex view is most likely related to
Acute sinusitis
Increased density and widening of the upper mediastinal with tracheal displacement would be consistent with
Substernal thyroid (thyrote)
Clinical symptomology related to bronchogenic cancer is often times non-specific. What percentage of patients with lung cancer are asymptomatic at the time of diagnosis
25
Pulmonary metastasis happens wthrough 3 mechanisms: hematogenous, lymphagenous, and contiguous direct extension. Direct extension pulmonary metastasis happns most commonly from
Pleural/pericardium
Calcification within pulmonary metastatic nodules would suggest which type of primary cancer
Osteosarcoma
Rectal gas helps to discriminate between paralytic/adyramic ilius and mechanic/obstructive ilius
True
3 major mediasitnal organs are esophagus trachea and aorta. Mnost commonly middle mediastinal masses are from
Lymph nodes
Hylar mediastinal lymphadenopathy is most often due to ___ in young patients and ___ in older patients
Sarcoidosis
Lung cancer
The analogy of the basketball under the blanket or on top of the blandket helps differentiate lung lesions from
AOTA
…mediastinum is indicative of what
Unithorax volume change
Clinical suspicion of lobar pneumonia is confirmed by which imaging procedure intiially
Plain film
Optimum imaging for pulmonary detail is what
Apical lordotic CT scanning
Which of teh following signs would point to air space consolidation
Bilateral medullary lung opacification Subsegmental poorly defined opacity 5-8mm acinar nodules Lobar opacification Poorly defined segmental opacification
A common cause for bronchopneumonia pattern is
Staph aureus
Enlargement of bronchi secondary to destruction of the muscular elements and elastic fibers of the bronchial walls caused by chronic infectipon is referred to as
Bronchiectasis
Which fo the following are signs of interstitial disease
1-2mm nodules Honeycomb densitites 3-5mm nodules Reticulonodular densitites Kerley lines
Which fo the follwoing are signs assocaited with atelectasis
Vascular crowding
Hilar shift towards density
Rib interspace narrowing
Elevation of diaphragm
Acute infectious pneumonias
Pneumococcal pneumonia
Staph aureus pne
Klebsieela pneu
Viral pneu
TB pneumonia is acute infecious pneumonia
False
Pulmonary consolidation in this segment can cause a silhouette sign with the ascending aorta
Anterior segement of RUL
Kartageners is associated with which pulmonary disorder
Bronchiectasis
Which cause of radiolucent pulmonary cystic cavitary type sapce is liekly to be seen in children
Pneumatocele
Kelbsiella pneumonia may cause lobar consolidation however a classic cause is
Strep pneumonia
Which of the following is NOT a hypersensitivity related disorder
Silo fillers disease - NO2
Irritant gases and chemical produce which form of pulmonary disease
Lobar consolidation
Which are considered to be fibrogenic pneumoconiosis
Silicosis
Asbestosis
Black lung disease
Beryllium grnaulomatosis
Indirect signs of lung collapse are
Unilateral hemodiaphragm elevation
Mediastinal deviation
Rib interspace narrowing
Sequelae of previous granulomatous infection include
Calcified granuloma Splenic calcificiation Upper lung fibrosis Calcified lymph nodes Pleura calcification
End stage silicosis is characterized by which radiographic finding
Ribrotic masses adjacent to upper mediastinum
The gohn tuberculum is
A tuberculum granuloma
Which are findings that can be assocaited with pulmonary TB
Lymphadenopathy
Of teh acute infections, cavitation si most likely to be associated with
Staph aureus
Multiple cystic radiolucencies scattered thorughout the lung field would not typically be associated with
Squamous cell carcinoma
On a chest series the findings are: unilateral localized homogenous increase in radiodensity. What are the next considerations
Consolidation
Atelectasis
Tumor
With acute pulmonary infections
Staph aureus pneumonia produces pneumatocele in children
Complications of honeycomb lung
Cor pulmonale
Hypersensitivity pneumonitits which is intrinsic allergic alveolitis is associated with
Bird fanciers lung
Humidifier lung
Which accessory fissure anatomically is made up of 4 pleural layers
Azygous fissue
Which 2 of the following would be associated with egg shell lymph node calcificiation
Silicosis
Sarcoidosis
The superior accessory fissure
Divides RLL into 4 basilar segement and 1 sup segment
Splits LLLL segment from basilar segments
Aspiration pneumonitis has an affinity for
Lower lobes
Kartageners bronchiectasis may have associated
Sitis and bursus totalis commonly in the RLL
TB is
Apical pleural calcification
Streptococcus pneumonia
Most common acute bacterial infection
When the lingula is atelectatic the
Left cardiac border is usually obliterated
What is the principle mechanism for atelectasis with a large hilar related neoplasm
Obstructive (or resorption)
Which fothe following asbestosis signs is considered virtually pathognomonic
Linear diaphragmatic pleural calcification
Erasmus syndrome
CWP with scleroderma
Pelural calcification and thickening would suggest the possibility of previeous
TB
High speed deceleration trauma to the chest may result in pulmonary contusion or
Bilateral medullary lung opacification
Which is in the subdifferential of multiple pulmonary cavitations
Hematogenous metastasis
Which if not true regarding stap pneumonia
Begins peripherally in teh lung
Silhouette sign is caused by
Water density lesion in anatomic contact with the herat aorta or diaphragm
The chest x-ray may be normal with
Acute bronchitis
Which fo the following is not a consoildation sign
Hilar displacement towards increasing density
Air bronchogram sign
Physical air filled bronchi surrounded by opacified lung
Which pulmonary cavitation cuase is not related to tissue necrosis
Rheumatoid nodule
Kerley’s an and b lines are indicative of
Interstitial disease
Metastasis to the lung in thyroid cancer will present as
Multiple evenly distributed nodules 3-5 in size
Localized hyperlucency could be associated with all of the following except
Emphysema (pneumothorax, pneumatocele, foregin object aspiration)
The most common causes for air space consolidation are
Blood Pus Water Cells Protein
Upper left heart border silhouette sign may be produced by
LUL #4 pneumonia
Suspected pleural effusion on a full inspiration PA chest view could be confirmed by
Lateral decubitus with involved side down
Most common cause for adult resorption atelectasis is
Bronchogenic cancer
Children = foreign object aspiration
2 RUL
Ascending aorta
5 RML
Heart (RA)
1-3 LUL
Aortic knob
2 LUL
Pulmonary artery
4 LUL
Left atrium
5 LUL
Left ventricle
6 LUL
Upper descending aorta
7-10 LUL
Diaphragm
